Blog

Dehydration

June 20, 2023

As we are in our hottest run of hot weather yet this summer the topic of dehydration has come up multiple times in the clinic. Keeping properly hydrated is important for our normal health, but becomes increasingly important as we are healing and as we are dealing with increased temperatures.

Dehydration is caused by losing more fluids than we take in. This can cause a host of issues in our bodies due to the imbalance of fluid and nutrients that it causes. Some early signs of dehydration are a dry mouth, feeling thirst, feeling tired, urinating less, or having urine that smells or looks differently. 

Dehydration can affect anyone, but being an athlete or active adult, having chronic medical conditions, or recovering from an illness or procedure can make you more susceptible to dehydration.

If you are experiencing any of these issues it is important to remember to try to drink more fluids. If doing this makes you feel sick, then you need to take more frequent smaller drinks. Try to avoid any flavored or carbonated beverages. Tea and coffee may also not be the best choice when trying to get rehydrated. 

Staying hydrated will keep your blood levels up and flowing through your body. This allows for the nutrients and oxygen that you need to feel you best and that your tissues need to heal. It is recommended adults should drink at least 64 ounces of fluid per day. If you are at risk for dehydration that amount should be increased. 

Perhaps a water bottle (Witte Physical Therapy has some!) should be just as important of an accessory to carry around with you as your phone is!

References:

https://www.nhsinform.scot/illnesses-and-conditions/nutritional/dehydration#:~:text=Dehydration%20is%20caused%20by%20not,of%20physical%20activity%20and%20diet.

https://extension.usu.edu/news_sections/home_family_and_food/summer-hydration

How to Travel After Surgery

June 13, 2023

It is summer! It is a great time of year to get out and enjoy the outdoors, catch a ball game, and take that family vacation. Unfortunately some of us need to have surgery in the summer. This could be elective or not our choice, but regardless of the reason surgery does not need to put a damper on your summer travel plans. Here are some tips to think about when you are preparing to travel after a surgery.

Travel with someone: After a procedure it is important to have a buddy when you travel. Whether you are driving a car or flying, traveling alone can contain some risks. These include faster fatigue, balance or gait issues, or some other rare side effects that your physician went over with you prior to traveling. Having a buddy with you ensures that there is an extra set of eyes to keep you safe.

Keep moving: After any procedure it is important not to sit too long. We want to get up and move every hour or two to keep our blood flowing. This also helps with trying to minimize blood clots, can work to improve swelling, and can keep fluid out of our lungs. 

Stay hydrated: This is a tip we all could probably do a better job of. Keeping our fluid intake up after a procedure if key in recovery. It is also another requirement in trying to avoid a blood clot.

Dress appropriately: We want to avoid wearing any restrictive clothing. As we travel and become active we may not be able to control or predict our swelling patterns. Restrictive clothing can be very uncomfortable and hinder blood circulation after surgery. Wear something loose and comfortable. 

Avoid stress: Traveling can be stressful, especially if you are on a schedule that you have to keep. Giving yourself extra time to get where you need to go can take some of the stress of traveling.

It is always important to talk to your surgeon about your travel plans to make sure that you know the risks and are aware of any precautions that you need to take. Having these conversations and proper planning can keep you safe and allow you to “let loose” this summer!

References:

https://newsnetwork.mayoclinic.org/discussion/when-your-summer-travel-includes-surgery-mayo-clinic-expert-offers-tips-for-a-safe-trip-2/

Witte Physical Therapy Areas of Concentration: Pediatric Physical Therapy

June 6, 2023

As a small community physical therapy company, we try to be as many things to as many people as we can. We try to serve our community both inside our clinic and outside.

Outside of our clinic we work to support many different groups and organizations to ensure they have the resources they need to continue to thrive in and serve their communities. We provide community service and work to be an advocate for our communities by being involved with different groups and boards.

Inside of our clinics we have worked to assemble a staff that puts patients first. They work to build an individualized plan for each patient so that not all patients who have had a total knee replacement get the same plan. We have also worked to get our staff extra training and experience in many different aspects of physical therapy. We have an orthopedic certified specialist on board. We have a therapist who has taken a special interest and more advanced training in vestibular and balance therapies. We have a therapist who has seen and worked with a variety of women’s health issues. And finally, we have a therapist who has an extensive background in pediatric therapy. These are just a few of the areas that we have tried to work with as many patients as possible for our therapists. Today, let’s focus on our pediatric population and what we can do to help.

We are not a clinic that says we can see everyone. In the pediatric population there is a group of patients who need to be seen in a more complex setting. However, we can help many of our pediatric patients with their concerns. We can work with the on different aspects of the injuries, musculoskeletal, neuromuscular, or other developmental disorders. We can provide a clinic that is close to home and often smaller and less hectic than the larger clinics or health centers. This often helps kids stay calm and focused during their treatment. We can provide education and guidance on the disorders that are plaguing them and work with their families on plans for home and their improvement. We can work with other providers for adaptive equipment and enhancements to make their lives easier. We can not only provide their therapy care but be an advocate for what they need and work to help them obtain those items.

If you have a child who could use some physical therapy or you could use a resource to talk to about their healthcare, give us a call!

Family Health and Fitness

May 30, 2023

As we continue to look at our overall wellness and the role that physical therapy (and our 24/7 Wellness Center) can play it is important to note an upcoming date. The second Saturday in June (June 10th) is Family Health and Fitness Day. It is a day designed to promote the parks and rec departments of our local communities, county, and state. It notes the importance using these local and state resources to get our with your family, enjoy the outdoors, and get active. 

For some people getting and being active can create two problems. The issues that come with starting to become more active and the issues that come with an increased or prolonged active lifestyle. Physical therapy can help with both of these issues. Sometimes before starting a new activity it is important to get checked out in the muscles and joints that will be challenged with that activity. Physical therapy can be used to check out for issues before you start something new. You can get specific stretches or exercises to make sure that you are prepared for the new activity. Once you have started the new activity sometimes the repetition of your new favorite activity can cause issues over time. Repeatedly doing the some routine or movement can wear out joints and muscles faster and thus physical therapy could be needed to help with these issues. Physical therapy can work to identify the movement pattern, ensure that it is being done correctly and without compensation, and work to adjust your activity to avoid these repetitive motions. 

At Witte Physical Therapy we also have the benefit of  having a 24/7 Wellness facility attached to our clinic. This allows for our patients to go back and forth and utilize both facilities and see our therapists in both places. We can use traditional physical therapy methods in the clinic or more advanced work in the wellness facility. If you would like a chance to see our facilities, meet our therapists, or have a free consultation to discuss your options give us a call!

Movement is Medicine: Physical Therapy & Arthritis

May 23, 2023

May is national arthritis month. Arthritis may seem relatively benign – everyone knows someone who has arthritis. But here are some numbers that help put the problem of arthritis into perspective:

• Arthritis is the leading cause of disability.
• Arthritis affects 1 in 5 adults and 300,000 children
• 1/3 of working-age people with arthritis have some kind of limitation in their ability to work
• Arthritis costs $156 billion each year in medical expenses and lost wages
• Nearly 1 million hospitalizations happen each year due to arthritis

It’s a serious condition, and a serious problem. The good news is that physical therapy is one of the most effective treatments for arthritis.

The Benefits of Physical Therapy for Managing Arthritis Symptoms

Arthritis comes in 2 forms: osteoarthritis and rheumatoid arthritis. Osteoarthritis occurs because of wear and tear on the joints over time. Rheumatoid arthritis is an inflammatory, autoimmune disease. It occurs because of the immune system attacking the joint lining. Physical therapy can reduce joint pain, improve mobility, and help to prevent further damage to the joints. Using individualized exercises, physical therapists help people manage their condition and reduce discomfort. Physical therapists often combine advice on lifestyle modifications with exercise to maximize improvement. Let’s look at the types of exercise that can help manage arthritis symptoms next.

Range of Motion Exercises

These gently move affected joints through their entire range of motion. This can help reduce stiffness and improve mobility. Examples would include things like gentle stretching, tai chi, or gentle yoga.

Aerobic Exercise

Aerobic exercise creates repeated motion, moving the synovial fluid in the joints. It also increases blood flow and releases endorphins which reduce pain. Aerobic exercise also helps to control weight. Weight loss is proven to reduce the stress on your joints, which can reduce pain. Aerobic exercise for people with arthritis should be low impact. This would include things like walking, cycling, or swimming.

Strength Training

Strength training is an important part of managing arthritis. It decreases pain, improves strength, and function. Stronger muscles around the affected joints provide better support and protection.

Aquatic Exercise

Exercising in a therapeutic pool can be a great way for people with arthritis to get started. The buoyancy of the water helps to relieve some of the body’s pressure on the joints. The water pressure also provides compression on the joints. This offers some stability and pain relief. The movement of your body through the water creates resistance for your muscles. This allows them to get stronger in a protective environment.

Education

Besides designing a custom exercise program, a physical therapist will educate people with arthritis on lifestyle modifications to help mange their symptoms. Some suggestions might include weight loss, getting enough sleep, eating a healthy diet, and managing stress. A PT can also modify daily activities to help protect joints affected by arthritis. This can slow down or prevent progression of symptoms.

Physical therapy is a safe and effective treatment for arthritis. Current clinical guidelines for treating arthritis include strong recommendations for exercise and other physical therapy treatments. If you’re one of the 53 million Americans with arthritis, give your PT a call. They’re a great provider to help you reduce pain, manage your symptoms, and move better.

References:

• Research (peer-reviewed)
  1. Knee osteoarthritis: key treatments and implications for physical therapy- https://www.sciencedirect.com/science/article/abs/pii/S1413355520302434
  2. Osteoarthritis Management: Updated Guidelines from the American College of Rheumatology and Arthritis Foundation – https://www.aafp.org/pubs/afp/issues/2021/0115/p120.html
  3. Physical therapy for patients with knee and hip osteoarthritis: supervised, active treatment is current best practice – https://sport-physiotherapie-halle41.ch/wp-content/uploads/2021/03/9-Physical-therapy-for-patients-with-knee-and-hip-osteoarthritis-2019.pdf
• Articles and Content
  1. May Is National Arthritis Awareness Month – News

Benefits of Exercise for Osteoarthritis | Arthritis FoundationHow Can Physical Therapy Help to Avoid Surgery? – Tucson Orthopaedic Institute

What are the different types of arthritis?

May 16, 2023

When we hear the word “arthritis” most of us think about replacing our hips or our knees. Some of us might think about replacing our shoulder or the pain at the base of our thumb that we feel. But there are different kinds of arthritis and how they are treated depends on what type of arthritis you have. 

According to the CDC the types of arthritis are:

Osteoarthritis: This is the most common type of arthritis and it is the one that we think about when we talk about joint replacements. Osteoarthritis occurs when the cartilage in a joint breaks down causing a “bone on bone” situation. These changes are gradual and tend to cause stiffness and pain.

Rheumatoid Arthritis: Is an autoimmune and inflammatory disease where the body attacks its own joints and causes pain and inflammation. We often see this type of arthritis in our wrist and fingers that cause some deformity and swelling. You can get pain and stiffness, but also show signs of infection such as fever and weight loss.

Childhood Arthritis: This is another type of rheumatoid arthritis and is often seen in children and juveniles.  This often makes any tasks difficult for that child to do. Remission of this disease is possible so there is hope for the children to “overcome” it. 

Fibromyalgia: This condition causes widespread pain throughout the body and is often diagnosed after testing for all other medical issues have come back negative. It tends to cause issue with sleep, fatigue and emotional or mental stress. 

Gout: This is a very painful, inflammatory condition of a single joint (usually) that occurs is it flares up in the body. It is often managed with medications, diet, and other activity adjustments. Limiting processed foods and alcohol can help keep uric acid levels lower in your body to help prevent flare ups and keeping them in remission.

Lupus: It is a chronic, autoimmune disease that can damage any part of your body. Symptoms can include pain, fever, rash, hair loss, amongst others. 

As you can see there are several different types of arthritis. There are some common items (inflammation, pain) and some uncommon items between them. However all can be assessed and treated with physical therapy. Physical is not a cure all for these things, but it can help make life better, decrease your pain, and improve your activity level. 

References:

https://www.cdc.gov/arthritis/basics/types.html

How to Prepare Your Shoulder For Softball, Baseball, or Adult Leagues

May 9, 2023

As we work to wrap up spring ball and get into summer ball activities it is important to remember to take care of our throwing shoulders. In the spring as we ramp up our throwing activities it is easy to remember to get your shoulder ready for the seasons. However, as the season progresses and it gets warmer outside it is often forgot to take care of our shoulders as well as we did before. We all know about pitch counts and how important they are, but just as important is a proper warm up before throwing, cool down after throwing, and icing after activity.

An easy program to remember to help get our shoulders strong, warmed up, and to try to avoid injury is the Thrower’s Ten program. This program was been developed over the years to work on all aspects of shoulder strength and stability. Addressing scapular strength, tracking, rotator cuff strength and stability, and all accessory muscles it ensures that your arm is ready for the season.

A great resource for diagrams and descriptions of each exercise of the program can be found at: https://www.ortho.ufl.edu/sites/ortho.ufl.edu/files/handouts/Throwers-Ten_0.pdf

It is important to note that to fully maximize the benefits of this program is should be tailored to what you need. Exercise adjustments, set and reps, and frequency should all be set by an appropriate medical professional so that you get what you need. The therapists at Witte Physical Therapy can help with this!

Functional Ankle Stability

May 2, 2o23

Most of us are aware of our loss of balance as we begin to age. We no longer have the ability to keep upright and in line as easily as we once did. Growing up, we could run, jump, ski, or hike and never feel a sense of unsteadiness. Over the years the body changes, and we are suddenly all too aware of the uneven ground beneath our feet. Our joints feel every curve, bump, and slant, creating a sense of hesitancy as we walk and even a fear of falling. What many of us don’t realize is that this can be aided! With skilled care, we can take back control of our bodies as we walk about our homes or communities. It all starts with proprioception. But what is proprioception? And how do we re-train our bodies to maintain balance?

                Proprioception, according to Physiopedia, is our sense of joint or limb positioning. This sense essentially tells our brains where our bodies are in space. It allows us to replicate a position our arm or ankle, for example, was just placed in. Proprioceptors have the ability to send this information to the brain and allow us to react appropriately to avoid falling. Natural wear and tear of our joints, ligaments, tendons, and muscles causes a deficit in our proprioceptors, making it more challenging to stay on our feet.

                With an increase in hesitancy and heightened fear of falling, our anxiety has a tendency to take over. Being overly cautious with our movements can sometimes be detrimental to our recovery. This caution may create a greater reliance on assistive devices, such as walkers or canes, further decreasing our proprioception and balance if used for a prolonged period of time. Luckily for us, the cure may be easier than you think! With persistent practice in balance, we can re-gain the confidence needed to walk independently.

                There are many different ways to practice improving balance and proprioception. It could be as simple as standing with your feet together while you brush your teeth at night. Too easy? Try standing on a folded blanket or pillow! If you break down the walking sequence, you will see we spend about half our time on only one foot! Practice this—standing on one foot, first on a solid and flat surface, then on something a little wobblier. Soon you will gain the courage needed to walk without assistance, without a device, and without the fear of falling! 3 easy exercises to begin your proprioception training are as follows:

                As suggested, begin with your feet close together or with one in front of the other. When you feel confident and steady, you can progress to just one foot.

                While sitting on a ball isn’t actually replicating your standing activities, it is a great way to train the entire body in stability! This will carry over into your daily activities! If sitting still is too easy, place a couple items around you and practice reaching for them while keeping steady!

                Standing on an uneven surface is a great way to train the muscles and proprioceptors needed to walk on gravel or grass. To make it harder, you can add leg or arm movements in different directions.

Balance is an issue for many patients that come to see us, young or old, injured or not. It is an aspect of our health that we must be diligent in training if we want to keep upright and avoid falls. If you are struggling with balance and aren’t sure where to begin, call us therapists down on Witte Physical Therapy for an assessment, and we will create a treatment plan to help you reach your goals!

Resources:

https://www.physio-pedia.com/Proprioception

https://www.friendsofpolarbear.com/post/proprioception-training-exercises-after-sprained-ankle

https://www.physio.co.uk/treatments/physiotherapy/proprioceptive-exercise.php

How to Deal with Shin Splints

April 25, 2023

Shin splints can be a painful part of being an active person, especially one who enjoys running. You can get shin splints when you first start to ramp up an activity or when you are logging a lot of miles. Shin splints are caused by the irritation of the inside border of the tibia (shin bone) as our ligaments and tendons pull apart from that bone. Symptoms include pain that worsens with activity. If left untreated shin splints can lead to stress fractures. Shin splints are one of the more common overuse injuries one can get and usually can be resolved with rest and ice. 

What if ice and rest do not work of if you don’t feel like you can take time off from these activities? Physical therapy can help to improve the healing time of shin splints. Using ultrasound and other modalities we can work to decrease the inflammation. Physical therapy will work to find and correct any issues in your mechanics. We can use exercise, manual therapy, shoe and activity modifications to help with these mechanics and to work to keep you active. Some examples of these are improving lower extremity flexibility, managing your exercise load, strengthening and supporting your hips, knees, and feet. Knee compression sleeves or orthotics can also be utilized. As the pain gets better and you are healing we can work to help you gradually return to full activity and running to work to avoid other flareups and issues. 

References:

https://my.clevelandclinic.org/health/diseases/17467-shin-splints#:~:text=Shin%20splints%20are%20a%20very,into%20a%20tibial%20stress%20fracture.

https://www.choosept.com/health-tips/8-tips-prevent-shin-splints

Witte Physical Therapy….to….Witte 24/7 Wellness

April 18, 2023

We often think of physical therapy as the place to go after a surgery or major injury. Over the years physical therapy has become more of a place to go when we have pain, issues with balance, or problems doing things that we want to do. But physical therapy can also be a place to go to prevent injury and promote wellness. This last aspect of physical therapy is often the one that gets overlooked.

When Witte Physical Therapy moved into its new location in Louisville in 2019, we wanted to provide resources to the community beyond basic and normal physical therapy. We opened Witte 24/7 Wellness as an avenue for that. Witte 24/7 Wellness is a fitness facility that is open 24 hours a day, 7 days a week, 365 days a year. It provides an outlet for anyone to improve their aerobic capacity, baseline strength, and overall wellness. With equipment ranging from treadmills, bikes, and ellipticals to cable machines, free weights, and a Smith machine, we have equipment for every member of the facility to utilize. We even have a stair stepper, a water rower, a personal trainer, and an exercise physiologist.

Our exercise physiologist, Alex Trautman, is also one of our physical therapists. This allows us to work with patients on injury prevention in the clinic and then transition our patients into our Wellness center for continue to work on lifetime gains and benefits. This is one of our goals with our patients. Whether you are recovering from an injury or surgery or working to prevent any future injuries or surgeries, our therapists can work with you on a transition plan from our clinic into a Wellness facility. Alex has special training in this area and enjoys getting to work with patients in both settings. Imagine being able to take your PT “with you” after you leave the clinic, what an advantage!

At Witte Physical Therapy our goal is to never see you twice for the same thing. We want to work to get you pain free, moving and feeling better and then give you the tools to maintain and prevent future injuries. Our therapists are trained in this and our facilities allow us to work with to transition you away from the clinic and into your home or a Wellness center.